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NPI Code Detail

MEDICARE: MARTHA CALZADILLA

MEDICARE: MARTHA CALZADILLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1174024087
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA CALZADILLA
Provider Business Mailing Address
First Line : 5380 BRIDGETTE WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-6944
Country : US
Telephone Number : 702-478-0214
Fax Number :
Provider Business Practice Location Address
First Line : 4350 ARVILLE ST STE 40
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3811
Country : US
Telephone Number : 702-202-3184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2018
Last Update Date : 06/16/2018

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Directions to “ MARTHA CALZADILLA ” Practice Location

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